Current Use of Botulinum A Toxin in Overactive Bladder Management

Abstract

Overactive bladder (OAB), which is refractory to oral medications, is a challenging condition. Patients with refractory idiopathic OAB often have severe symptoms and impaired quality of life. Those with neurogenic bladder carry the potential for high voiding pressures and damage to their upper and lower urinary tract. Botulinum A toxin, injected under cystoscopic guidance, offers a promising, reversible, acceptably invasive treatment option. A growing body of research has demonstrated its effectiveness in reducing OAB symptoms, improving both urodynamic parameters and quality-of-life measures. However, the potential for inadvertent urinary retention (impacting primarily the idiopathic group) and need for repeat cystoscopic administration limit its acceptability. Although important questions surrounding use remain, botulinum A toxin injections can provide a well-tolerated, minimally invasive alternative treatment for the management of refractory OAB. This review focuses on the published literature from the past year.